Ultrasound, pelvis
Facility: Mercy Hospital Waldron
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $225
- Cash Discount Price: $508
- vs. Medicare Baseline: 2.11x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 211% of the Medicare baseline (a markup of 111%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $40 - $305 | 37% |
| Summit Community Care Contracted [320368] | $40 | 37% |
| Aetna | $90 - $508 | 84% |
| Humana | $90 - $664 | 84% |
| Arkansas Total Care Contracted [320039] | $91 | 85% |
| Blue Cross Blue Shield | $108 - $215 | 101% |
| Usable Contracted [320409] | $108 | 101% |
| Novasys Contracted [320285] | $143 - $305 | 134% |
| Tricare | $211 | 198% |
| American Health Advantage Of Mo Mcr [20264] | $215 | 201% |
| Cherokee Nation Health Serv Contracted [320066] | $215 | 201% |
| Cross Timbers Hospice [20098] | $215 | 201% |
| Dept Of Veteran Affairs Contracted [320106] | $215 | 201% |
| Elara Caring Aspire Hospice Contracted [320433] | $215 | 201% |
| Elara Caring Aspire Hospice [20433] | $215 | 201% |
| Globalhealth Contracted [320145] | $215 | 201% |
| Halo Hcr Inc Hospice Contracted [320432] | $215 | 201% |
| Halo Hcr Inc Hospice [20432] | $215 | 201% |
| Independent Health [20197] | $215 | 201% |
| Indian Health Service Contracted [320198] | $215 | 201% |
| Indian Health Service [20198] | $215 | 201% |
| Jordan Valley Senior Care Pace [20515] | $215 | 201% |
| Kindful Hospice Contracted [320434] | $215 | 201% |
| Kindful Hospice [20434] | $215 | 201% |
| Medical Associates Health [20444] | $215 | 201% |
| Medicare (plans) | $215 - $225 | 201% |
| Mercy Hospice Okc [20252] | $215 | 201% |
| Pace Of The Ozarks [20518] | $215 | 201% |
| Provider Partners Health Plans Contracted [320450] | $215 | 201% |
| Qual Choice Contracted [320325] | $215 | 201% |
| Spina Bifida Hlthcare Benefit [20506] | $215 | 201% |
| UnitedHealthcare | $215 - $252 | 201% |
| Valir Pace [20503] | $215 | 201% |
| Cigna | $225 - $664 | 211% |
| United Medical Resources Contracted [320454] | $252 | 236% |
| Qual Choice Contracted [320324] | $253 | 237% |
| Ambetter / Centene | $305 | 286% |
| Home State Health Plan Contracted [320187] | $305 | 286% |
| Mercy Interfacility [20513] | $348 | 326% |
| Auxiant Contracted [320462] | $469 - $703 | 439% |
| Mercy Benefit Admin Contracted [320251] | $469 - $703 | 439% |
| Workers Comp [20426] | $508 | 476% |
| 90 Degree Benefits Contracted [320436] | $664 | 622% |
| Aither Health Contracted [320449] | $664 | 622% |
| Ebms Contracted [320493] | $664 | 622% |
| Edison Health Solutions Contracted [320502] | $664 | 622% |
| Healthlink Contracted [320179] | $664 - $703 | 622% |
| Imagine 360 Contracted [320494] | $664 | 622% |
| Multiplan Contracted [320270] | $664 | 622% |
| Multiplan [20270] | $664 | 622% |
| Municipal Health Plan Contracted [320271] | $664 | 622% |
| Reflect Health Contracted [320492] | $664 | 622% |
| Show-Me Health Administrators Contracted [320483] | $664 | 622% |
| Federal Medical Center Contracted [320127] | $703 | 658% |
| Healthscope Contracted [320182] | $703 | 658% |
| Insurance System Inc Contracted [320465] | $703 | 658% |
| Personify Health Contracted [320051] | $703 | 658% |
| Point C Contracted [320238] | $703 | 658% |
| Preferred Health Plan Contracted [320522] | $703 | 658% |
| Tri State Healthcare Coalition Contracted [320379] | $703 | 658% |